Are Black Spots on Teeth Cavities?

A cavity. Decay that has broken through the enamel often looks brown to black, especially in the grooves of back teeth where the dark colour is taken up from food and from the decay itself.

Surface stain. Tea, coffee, tobacco, paan and some iron supplements and mouthwashes leave dark deposits, usually in the grooves and along the gum line. Stain is on the surface and does not mean the tooth is damaged.

Tartar. Hardened plaque can take on a dark brown or black colour, particularly just under the gum margin where it sits against the tooth.

A restoration or a dead tooth. A dark grey shadow showing through enamel may be an old metal filling beneath it, or a tooth that has darkened after an injury or a nerve that has died.

A rough guide only. Stain is usually flat and smooth to the tongue and often appears on several teeth in the same pattern. A cavity tends to be a single spot, feels like a pit or a soft patch, may catch food, and may be sensitive to sweet or cold.

Do not test it by picking at it with a pin or a toothpick. This can break the enamel and push bacteria into the tooth. The honest answer is that even dentists cannot always tell by sight alone, which is why an X-ray is part of the check. For what a cavity looks like through each stage, see what a cavity in teeth looks like.

Stain and tartar are removed by scaling and polishing, which takes one visit and needs no drilling. If what looked like a cavity comes off, that is a good result and it is common.

A cavity is cleaned out and restored. The size of the filling depends on how far the decay has gone, and which material suits the tooth is covered in types of dental fillings. The full process is on the tooth fillings page.

A tooth darkened by injury or a dead nerve needs an X-ray and sometimes root canal treatment, and a filling would not fix it. A filling or a root canal depends on whether the pulp is still alive.

In a child, a dark spot in the groove of a new back tooth is often early decay, because those grooves are deep and hard to brush. Dark patches on milk teeth near the gum line are also commonly decay. Both are worth an examination rather than waiting to see if they grow.

Do not scrub the spot with baking soda, lemon, charcoal or abrasive powders. They can wear enamel and make sensitivity and future staining worse, and they do nothing to a cavity underneath.

Do not wait for it to hurt. If the dark spot is a cavity, it is cheapest and smallest to treat while it is painless. If it is stain, finding that out costs one short visit.